Drowning Among Tunisian Children: Clinical Patterns and Outcomes

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PURPOSE: Describe clinical and therapeutic aspects of pediatric drowning and analyse predictive factors of mortality. METHODS: We conducted a retrospective analysis of patients under 16 years of age admitted between 2018 and 2022 to the Pediatric Intensive Care Unit at Farhat Hached University Hospital. RESULTS: Our study included 64 patients. The sex ratio was 1.46. The mean age was 7.1 ± 4.3 years. Most drowning occurred during the summer (92.2%), in seawater (76.6%). The mean estimated immersion time was 4 ± 5.8 minutes. The majority of these drownings (70.3%) were severe (stage 3, 4, 5, or 6). The most frequent clinical signs were: tachypnea (93.8%), auscultation abnormalities (93.8%), oxygen saturation < 92% (73.4%), and tachycardia (71.9%). Chest X-ray was abnormal in 75% of cases. Mechanical ventilation was indicated in 14.1% of cases. Vasopressor drugs were used in 12.5% of cases. Antibiotic therapy was initiated in 70.3% of patients. The mortality rate was 10.9%. In multivariate analysis, predictive factors for mortality were: a Szpilman stage equal to 6 (p <0.005), a Glasgow score < 8 (p <0.005), pupillary abnormalities (p <0.005), hypothermia < 35 (p<0.005), hepatic cytolysis (p = 0.02), and blood pH < 7.1 (p <0.005). CONCLUSIONS: Drowning is a fatal, yet preventable global public health problem, particularly touching children and young adults. Mortality depends on several epidemiological, clinical and biological factors.

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